scholarly journals Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as an Inflammatory Biomarker in Predicting the Severity of Secondary Brain Injury: A Review Article

2020 ◽  
Vol 8 (F) ◽  
pp. 272-282
Author(s):  
Gede Febby Pratama Kusuma ◽  
Sri Maliawan ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Tjokorda Gde Agung Senapathi
Keyword(s):  
Brain Injury ◽  
Causes Of Death ◽  
Review Article ◽  
Neutrophil To Lymphocyte Ratio ◽  
Secondary Brain Injury ◽  
Platelet To Lymphocyte Ratio ◽  
Inflammatory Reactions ◽  
Inflammatory Biomarker ◽  
Lymphocyte Ratio ◽  
Potential Biomarker

Traumatic brain injury (TBI) is one of the leading causes of death and disability, which affects millions of people globally with a significant economic burden. The inflammatory reactions and immune system activity play a significant role in the severity development of secondary brain injury (SBI) after a TBI event. Neutrophils, platelets, and lymphocytes are involved in these inflammatory reactions and have potential in reflecting the severity level of SBI that occurred post-TBI. Some recent studies have shown that the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) can be used as a potential biomarker for determining the severity of an inflammatory reaction, including SBIs in post-TBI. However, the results of NLR and PLR in TBI patients in daily medical practice are still not fully utilized. This review summarizes the neutrophil’s, platelet’s, and lymphocyte’s role in SBI, also the NLR and PLR potential as a marker of the severity of the SBI process in TBI cases.

scholarly journals Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio Correlations with C-reactive Protein and Erythrocyte Sedimentation Rate in Traumatic Brain Injury

2020 ◽  
Vol 8 (B) ◽  
pp. 1185-1192
Author(s):  
Gede Febby Pratama Kusuma ◽  
Sri Maliawan ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Tjokorda Gde Agung Senapathi ◽  
Anak Agung Wiradewi Lestari ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

BACKGROUND: Immune system and inflammatory response play an essential role in the development of secondary brain injury (SBI) after traumatic brain injury (TBI). An inflammatory biomarker that can reflect the SBI severity is needed to increase the effectivity of TBI management and prevent morbidity and mortality post-TBI. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are more affordable than C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), theoretically have the potential to be used as a marker of the SBI severity. However, NLR and PLR in daily medical practice are not yet fully utilized. AIM: The aim of the study was to correlate NLR and PLR with CRP and ESR as a marker of SBI severity post-TBI. METHODS: This cross-sectional study was conducted at Sanglah Hospital Denpasar from January to April 2020. Patients diagnosed with TBI were included in this study by consecutive sampling. The blood samples were taken at 24-h post-TBI to obtain the NLR, PLR, CRP, and ESR results. Spearman’s correlation test was conducted to determine the correlation between NLR and PLR with CRP and ESR. RESULTS: Eighty-five patients were included in data analysis. Median ± (interquartile range) of the NLR, PLR, CRP, and ESR were 7.60 ± (6.83), 145.58 ± (76.95), 60.83 ± (66.3), and 12.50 ± (13.85) consecutively. NLR and PLR had a significant positive correlation with CRP (r = 0.472, **p < 0.01; r = 0.283, **p < 0.01 consecutively). But, NLR and PLR were not correlated with ESR. CONCLUSION: NLR and PLR can become a useful and more affordable marker for reflecting the SBI severity in acute TBI.

Association Between Neutrophil to Lymphocyte Ratio and Malignant Brain Edema in Patients With Large Hemispheric Infarction

2020 ◽  
Vol 17 (4) ◽  
pp. 429-436
Author(s):  
Xueling Bai ◽  
Changyi Wang ◽  
Lu Wang ◽  
Shuai Jiang ◽  
Shihong Zhang ◽  
...  
Keyword(s):  
Brain Edema ◽  
Inflammatory Responses ◽  
Multivariate Logistic Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Secondary Brain Injury ◽  
Inflammatory Biomarker ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
Life Threatening ◽  
Hemispheric Infarction

Introduction: Malignant brain edema (MBE) is a life-threatening complication for patients with large hemispheric infarction (LHI). Stroke-related inflammatory responses may cause secondary brain injury and lead to brain edema. The neutrophil to lymphocyte ratio (NLR) is a well-known systemic inflammatory biomarker. The aim of this study was to evaluate if NLR is associated with MBE in patients with LHI. Methods: A retrospective analysis was performed of LHI patients within 24 h from stroke onset admitted to the Department of Neurology, West China Hospital from January 1, 2017 to December 31, 2018. Blood samples were collected upon admission. MBE was diagnosed by any neurological deterioration accompanied by brain edema in follow-up images. Patients were categorized according to NLR tertiles. Univariate analyses were performed to identify potential confounding variables and a multivariate logistic regression analysis was conducted to determine the correlation between NLR and MBE. Results: A total of 257 patients with a mean age of 68.6 ± 14.0 years were identified. Among them, 83 (32.3%) patients developed MBE with a median time of one day (interquartile range [IQR] 0-2 days) from hospital admission. An elevated NLR was related to an increased risk of MBE when the lowest and highest tertiles were compared (odds ratio 2.27, 95% confidence interval 1.11-4.62, p = 0.024). The risk of MBE increased with the increase of NLR in a dosedependent manner (p for trend = 0.029). No interaction between potential modifiers and NLR on MBE was observed. Conclusions: Higher NLR was associated with an increased risk of MBE in patients with LHI.

scholarly journals Neutrophil-to-Lymphocyte Ratio Is a Useful Marker for Predicting Histological Types of Early Gastric Cancer

2021 ◽  
Vol 10 (4) ◽  
pp. 791
Author(s):  
Sho Yasui ◽  
Tomoaki Takata ◽  
Yu Kamitani ◽  
Yukari Mae ◽  
Hiroki Kurumi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Inflammatory Response ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Histological Assessment ◽  
Lymphocyte Ratio ◽  
Undifferentiated Adenocarcinoma ◽  
Grade Of Malignancy ◽  
The Relationship

Background: The indications for endoscopic submucosal dissection (ESD) for gastric cancer are based on preoperative histological assessment; however, examination of tissue biopsy is not always reliable as only a limited portion of the lesion can be obtained. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammatory response and are potentially associated with the grade of malignancy in gastric cancer. We aimed to investigate the association between NLR and PLR and the histology of gastric cancer. Methods: This study included 218 patients who underwent ESD for gastric cancer. The relationship between NLR/PLR and histological diagnosis was investigated. Results: Patients with adenocarcinomas showed significantly higher NLR and PLR than those with adenomas (p < 0.001 and p < 0.05, respectively). Further, patients with undifferentiated adenocarcinoma showed a significantly higher NLR (p < 0.05) than those with differentiated adenocarcinoma. Conclusion: This study suggests that NLR could be a useful marker for assessing early gastric cancer.

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

scholarly journals Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

2021 ◽  
Author(s):  
Rohit Jain ◽  
Arun Gopal ◽  
Basant Kumar Pathak ◽  
Sourya Sourabh Mohakuda ◽  
TVSVGK Tilak ◽  
...  
Keyword(s):  
Disease Severity ◽  
Complete Blood Count ◽  
Wide Spectrum ◽  
Statistical Significance ◽  
Severe Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Screening Tools ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Time Of Admission

Abstract Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

scholarly journals The role of salivary vesicles as a potential inflammatory biomarker to detect traumatic brain injury in mixed martial artists

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rani Matuk ◽  
Mandy Pereira ◽  
Janette Baird ◽  
Mark Dooner ◽  
Yan Cheng ◽  
...  
Keyword(s):  
Gene Expression ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Injury Severity ◽  
Expression Profiles ◽  
High Impact ◽  
Impact Mechanism ◽  
Inflammatory Biomarker ◽  
Potential Biomarker

AbstractTraumatic brain injury (TBI) is of significant concern in the realm of high impact contact sports, including mixed martial arts (MMA). Extracellular vesicles (EVs) travel between the brain and oral cavity and may be isolated from salivary samples as a noninvasive biomarker of TBI. Salivary EVs may highlight acute neurocognitive or neuropathological changes, which may be particularly useful as a biomarker in high impact sports. Pre and post-fight samples of saliva were isolated from 8 MMA fighters and 7 from controls. Real-time PCR of salivary EVs was done using the TaqMan Human Inflammatory array. Gene expression profiles were compared pre-fight to post-fight as well as pre-fight to controls. Largest signals were noted for fighters sustaining a loss by technical knockout (higher impact mechanism of injury) or a full match culminating in referee decision (longer length of fight), while smaller signals were noted for fighters winning by joint or choke submission (lower impact mechanism as well as less time). A correlation was observed between absolute gene information signals and fight related markers of head injury severity. Gene expression was also significantly different in MMA fighters pre-fight compared to controls. Our findings suggest that salivary EVs as a potential biomarker in the acute period following head injury to identify injury severity and can help elucidate pathophysiological processes involved in TBI.

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